How is Milk Like Insulin Pumps?

Meet Bessie.


She’s a cow. She produces milk that her farmer sells to a large dairy so that people can drink it.

But not everyone likes milk produced by Bessie.

Other farmers offered different cows:



This cow (I’ve named her Daisy.) only eats organic grass.

She produces a different milk that her farmer also sells to a large dairy.

But other farmers, smaller farmers, offer milk… not from cows.

They offer milk from almond trees. (I’m not naming this tree. That’s all on you.)

They offer milk made from soybeans. (His name is Bob.)


And so everyone who wanted to drink milk could choose what type of milk they wanted:

  • milk from Bessie, or
  • milk from Daisy, or
  • milk from Bob or…
  • milk from the unnamed almond tree that you’ve named in your head, because you feel bad.

Some farmers couldn’t compete in the production of milk. They shuttered the barn doors. But other farmers continue to work on making their milk better and healthier, giving alternatives if one type of milk isn’t the best choice.

Most of that milk goes through dairies (Yes, I know that soy milk doesn’t go to a dairy. Work with me.) and we get that milk by paying dairies. Some dairies offer lots of choices; other dairies only carry one type of milk.

We pay them, we get milk. Sometimes we pay more, depending on what dairy program we use.

The dairies contract with the farmers to get the best price on milk.

One day, one of the largest dairies decide that they are not going to offer almond or soy or even organic milk to its customers.

Monopoly Milk

milk-container-1507753-639x852They have been talking with Bessie’s farmer and negotiated a deal to get a better price to save money. Part of the agreement is exclusivity. For the farmer, who is a business that gets paid by the dairy (and not those of us who drink milk), it’s a great proposition.

For those who drink milk from that dairy, you get Bessie milk or no milk at all.

Sure, you can go to another dairy, but some people can’t change dairies. They’re stuck. Who is angry?

  • The other farmers are angry. (They just aren’t large enough to be able to offer exclusivity because they have small farms.)
  • The customers of the dairy are angry. (What if you tried Bessie’s milk and it didn’t make you healthier, but Bob’s milk did?)
  • Friends of the customers of the dairy are angry. (They still get to choose milk from Daisy.)

Now, some of us like Bessie’s milk. And the farmer. Some of us don’t. Bessie isn’t for everyone and that’s OK.

Who Gets Poked By A Pitchfork Over Milk?


There’s a lot of anger and sharpening of pitchforks. But here’s the question. Who should you poke?

  • Should you poke the farmer because they are the largest and produce the most milk and offered a great financial incentive to the dairy? The dairy didn’t have to take the offer.
  • Should you poke the government, as some suggest? Would it help?

If you want to raise the pitchfork and poke at anything, direct your anger to the dairy. The dairy chose to stop selling different types of milk. The dairy is a business that is paid by customers and serve as the middleman between the farmers and the drinkers of milk. They did not have to sign an agreement that was offered. Customers can complain, but they need to complain to the right business: the dairy.

The dairy is the only entity that can give back the milk choices.  And the community should be the ones to get the dairy to give back the milk choices. Expend the effort on the dairy.

Now… some people who want milk can’t get any at all. Some dairies tell customers that they can’t have milk or they can’t afford the milk offered. And some customer don’t have dairies in their country. That is recognized. That’s another pitchfork rally, just not for today. Today, it’s about the choice of milk being taken away from paying customers. 

And If You’re Still Wondering How Milk Is Like Insulin Pumps?  

Hint: This is not about milk.

This is about access to different types of milk.

I like milk. All kinds of milk. I want to keep more than one farmer in business.

I like insulin pumps. I have used a few of them.

Milk = insulin pump in this post.

Let’s not cry over the spilled milk. Let’s make sure that there is more types of milk available to the community.



  1. I completely agree that complaints need to be directed at the insurer (or dairy, in this analogy). I sincerely wish I had been aware of this negotiation between the farmer and the dairy when I visited the farmer a couple of weeks ago. I just feel like I wasn’t entirely in the loop while this was going on. And while my knowledge isn’t necessary, I am within my rights to request that I, as a patient, be part of the process. Even though the farmer and the dairy would never allow it.

  2. Thank you for this post. A lot of people are angry, in fact, everyone should be angry. But, like you mentioned, I think it’s important to understand where your actions from your anger should be focused on.

  3. I find myself confused and conflicted by this. Sure, the dairy is at fault, but I can’t absolve the farmer of all wrongdoing either.

    Although the farmers each want to be a leader in the marketplace, they do rely on others to keep the market thriving (“Got Milk?”) and they cooperate with one another in order to do this. Otherwise people turn to juice or calcium supplements, and the whole industry crumbles.

    Additionally, farmers are humanitarians by nature. They care about their cows and they care about their customers. Customers will be much happier, and will portray their choices in a more positive light, if they actually CHOSE to drink Bessie’s milk rather than were force-fed it. Impressions matter– because maybe one dairy only offers Bessie’s milk, but Bessie’s milk is also available at different dairies in different towns- some of which offer choices. The choices those customers make will be largely affected by the reactions of those forced to drink Bessie’s milk, so it’s best to keep them happy.

    1. I agree with Scott. Especially since Bessie’s Farmer has already approached other Dairies with similar requests to make it the preferred milk brand, leading to access being jeopardized for other farmers’ milks. I also recall a few years ago, when the Milk-Drinking community was all up in arms about a particular farmer’s milk being described as “the next-generation of milk that blows all other milks away.” The farmer was called out for not doing more to prevent the confusion because it should have known that would happen, and the farmer even admitted later they could have done more to clear up confusion. Same thing. Farmer needs to be responsible and not force-feed their milk or say it is something that it’s not, and as a player in this universe it has the responsibility to play fair.

  4. The key is to have as many farmers and dairies as we can economically support. comeptition breeds innovation and lowers prices Limiting competition is not the best way to contain prices, never is and never has been except in the very short run.

    I referred your blog to the TUDiabetes web page for the week of May 2, 2016.

  5. I think your analogy to milk is a good one; the reality is that rationing of healthcare expenditures happens in all systems, but is more much noteworthy in a system designed to make money by denying coverage and minimizing expenditures. In the broader conversation, I think carving out a special discussion of pumps is not something we should do; instead we should include insulin, testing supplies and other medical devices as well as medical treatments more generally. That’s not being done right now; its only about pumps, and I don’t want to support efforts on that exclusively.

  6. […] media tidbits from all parties involved to get the gist of the story from a facts perspective. How is Milk like Insulin Pumps? – Christel/ThePerfectD’s analysis of what this means in a real-world example. Choice is […]

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